The Role of Lactate Metabolism in Heart Failure and Cardiogenic Shock: Clinical Insights and Therapeutic Implications.

Heart failure (HF) is associated with poor prognosis, especially when it progresses to cardiogenic shock (CS), where survival rates substantially decline. A key area of interest is the role of blood lactate as a biomarker in these conditions. Lactate is produced under normal physiological conditions but increases with impaired tissue perfusion, a hallmark of HF and CS.

Discontinuation and Reinitiation of Dual-Labeled GLP-1 Receptor Agonists Among US Adults With Overweight or Obesity.

Importance: Adherence to glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is important for their effectiveness. Discontinuation and reinitiation patterns are not well understood.

Objective: To describe rates of and factors associated with discontinuation and subsequent reinitiation of GLP-1 RAs among adults with overweight or obesity.

Nurse practitioner and physician associate mentorship: Improving retention and employment experiences.

Background: Clinician turnover is costly for health care organizations.

Local Problem: A retention strategy for newly hired nurse practitioners (NPs) and physician associates (PAs) was needed at our organization.

Methods: A quality improvement project was conducted to determine whether a mentorship program could improve retention and employment experiences of newly hired NPs and PAs.

Relationship Between Left Ventricular Ejection Fraction and ICD-10 Codes Among Patients Hospitalized With Heart Failure.

Introduction: While left ventricular ejection fraction (LVEF) represents an important means by which to classify patients with heart failure (HF), relatively little is known about the distribution of LVEFs among patients hospitalized for HF based on their International Classification of Disease (ICD)-10 code.

Methods: We performed a retrospective cross-sectional analysis of patients admitted to a large integrated health system within the western US between January 1, 2018 and October 1, 2022 with a principal diagnosis of HF (defined by ICD-10 codes: I50.2, systolic HF; I50.

Blueprint for Building and Sustaining a Cardiogenic Shock Program: Qualitative Survey of 12 US Programs.

Background: Multidisciplinary cardiogenic shock (CS) programs have been associated with improved outcomes, yet practical guidance for developing a CS program is lacking.

Methods: A survey on CS program development and operational best practices was administered to 12 institutions in diverse sociogeographic regions and practice settings. Common steps in program development were identified.

Emerging Educational and Networking Platforms in Interventional Cardiology: Expanding Beyond Traditional Social Media.

With ubiquitous use of smartphones and other Internet-enabled devices, clinicians have access to a plethora of multimedia platforms that enable them to network, share educational content, and learn. Several platforms also enable resources that support clinical decision making. Traditional social media has been used extensively by cardiologists for several years and now extends to the entire care team including trainees, advanced practitioners, nurses and technologists.

Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity.

Importance: Although tirzepatide and semaglutide were shown to reduce weight in randomized clinical trials, data from head-to-head comparisons in populations with overweight or obesity are not yet available.

Objective: To compare on-treatment weight loss and rates of gastrointestinal adverse events (AEs) among adults with overweight or obesity receiving tirzepatide or semaglutide labeled for type 2 diabetes (T2D) in a clinical setting.

Design, Setting, And Participants: In this cohort study, adults with overweight or obesity receiving semaglutide or tirzepatide between May 2022 and September 2023 were identified using electronic health record (EHR) data linked to dispensing information from a collective of US health care systems.

Retrospective analysis of acute ischemic stroke shows timing of antidepressant use associated with short-term recovery and functional independence at 90-days.

Background: Little is known about how the timing of antidepressant use influences stroke outcomes. Previous research shows conflicting results on the impact of a new antidepressant prescription on stroke recovery.

Objective: The objective of this exploratory, retrospective analysis is to examine stroke outcomes by timing of antidepressant use among patients who received stroke treatment.

Sepsis Order Set Use Associated With Increased Care Value.

Background: Sepsis is common and expensive, and evidence suggests that sepsis order sets may help to improve care. Very incomplete evidence exists regarding the effects of sepsis order sets on the value of care produced by hospitals or the societal costs of sepsis care.

Research Question: In patients hospitalized for sepsis, is the receipt a of a sepsis order set vs no order set associated with improved value of care, defined as decreased hospital mortality, decreased hospital direct variable costs, and decreased societal spending on hospitalizations?

Study Design And Methods: This retrospective cohort study included patients discharged with sepsis International Classification of Diseases, Tenth Revision, codes over 2 years from a large integrated delivery system.

Biological effects of intraoperative radiation therapy: histopathological changes and immunomodulation in breast cancer patients.

Introduction: Intraoperative radiation therapy (IORT) delivers a single accelerated radiation dose to the breast tumor bed during breast-conserving surgery (BCS). The synergistic biologic effects of simultaneous surgery and radiation remain unclear. This study explores the cellular and molecular changes induced by IORT in the tumor microenvironment and its impact on the immune response modulation.

Optimizing Care Delivery in Patients with Chronic Kidney Disease in the United States: Proceedings of a Multidisciplinary Roundtable Discussion and Literature Review.

Background: Approximately 37 million individuals in the United States (US) have chronic kidney disease (CKD). Patients with CKD have a substantial morbidity and mortality, which contributes to a huge economic burden to the healthcare system. A limited number of clinical pathways or defined workflows exist for CKD care delivery in the US, primarily due to a lower prioritization of CKD care within health systems compared with other areas (e.

Adoption and clinical outcomes of fenestrated endovascular aneurysm repair in a regional, multistate community hospital system.

Objective: Complex endovascular abdominal aortic aneurysm (AAA) repair techniques have evolved over the last decade, yet patterns of physician and hospital system adoption of fenestrated endovascular aneurysm repair (FEVAR) remain poorly defined. We investigated clinical outcomes, use trends, and surgeon and hospital experience for FEVAR in a large community hospital system.

Methods: We conducted a retrospective cohort study of all FEVAR procedures within our 5-state hospital system between April 2012 and June 2021.